For the goal of this essay, I'll use Gibbs (1988) Reflective Learning Circuit to think about an element of individual professional practice, which requires development in preparation for my role as a RN. Gibbs (1988) Reflective Learning Circuit encourages a specific description of a situation, analysis of emotions, evaluation of the experience and analysis to make sense of the experience to examine what you will do if the problem arose again.
To keep within the Nursing and Midwifery Council (NMC) Code of Professional Conduct guidelines (2008a) and also to maintain confidentiality the utilization of brands or places will never be used throughout this article.
Description
Whilst on placement working on an over-all ward within my third year I got asked to research a drug I got doubtful about by my coach. On my way to analyze the drug I got approached by a health care associate who asked me if I could assist her with a patient who was laying in a soiled bed. I thought we would help the health care assistant when i thought this is priority as I could research the drug at any point in your day as it was for my own learning and development and wasn't urgent. After I experienced helped the health care helper, my mentor asked easily had explored the drug. I explained that I had opted to help medical care associate and would now research the drug, which I then does. My coach then told me that I had a need to improve on my time management, as I had not viewed up the drug when she asked me to. She carried on explaining that when I become a Registered Nurse I would need to find out drugs and what they are used for. This situation kept me questioning which was the concern, the patient's needs or my own professional learning and development.
Feelings
I automatically helped the health good care assistant to make the individual comfortable as I felt that was the goal over researching the medicine. I remember thinking that I could do this at home if the ward became busy. I felt irritated with myself for not speaking up to my coach about the issue as I had thought I put made the right decision to help the individual. I was concerned about the patients comfort and sensed I could not justify leaving the patient lying down in a soiled foundation because I put to analyze a medication. Nurses have to be able to justify the decisions they make (NMC 2008a).
After the occurrence, being informed by my mentor that I needed to improve on my time management skills because I thought we would assist the health care assistant lost me just a little. This practice experience made me feel as if I had a need to learn and develop more regarding my time management skills. I decided I'd have to research into the meaning of 'time management' when i thought that my time management skills were fine. I used to be always promptly for my transfer and I would make a list of the jobs I needed to do and prioritise them. This experience made me question can certainly make money was prioritising my workload at the moment.
Evaluation
I thought we would assist the health care associate in ensuring the individual was clean and comfortable and believed that this was the goal in this example. As an responsible practitioner the NMC (2008a) says 'you must make the good care of men and women your first matter, dealing with them as individuals and respecting their dignity' that i did. I possibly could know very well what my mentor was explaining to me, that as a RN I must be able to really know what different drugs are and what they are used for. As an accountable practitioner, I must have the data and skills for safe and effective practice when working without direct supervision, understand, and work within the boundaries of my competence. I have to also keep my knowledge and skills up to date throughout my working life and I have to take part in appropriate learning and practice activities that maintain and develop my competence and performance (NMC 2008a). Post-registration education and practice (Prep) is a couple of Medical & Midwifery Council benchmarks and guidance, which is designed to help you give a high standard of practice and care and attention. Prep helps you to keep up to date with new improvements in practice and encourages you to believe and reflect for your own. It also enables you to demonstrate to the people in your care, your co-workers and yourself that you will be keeping up up to now and producing your practice. Prep provides a fantastic framework for your continuing professional development (CPD), which, although not a guarantee of competence, but is an essential component of clinical governance (NMC 2008b). Following this experience my matter was which is the top priority and which was not and that if I experienced have researched the drug I'd have been departing the individual in a soiled bed until I had formed done it.
Analysis
As Individuals, we do not invent the concept of time, but we learn about it, both as a thought and a sociable institution, from years as a child onwards. In the Western world, time has been created around devices of way of measuring, such as clocks, calendars and schedules (Elias 1992). A study by Waterworth (1995) explored the worthiness of nursing practice from the viewpoint of experts, she identified that time with patients is important, but increases the question of how nurses control their time.
The need for time management will affect me sooner or later in my job as a RN. I am inundated with work and I'll need to evaluate how to control my time effectively. Time management is a strong process. It really is constant activities and marketing communications between you and your goals and working with changing situations (Brumm 2000). Time management will go together with good prioritisation skills, which indicate managing your time, deciding upon priorities and planning appropriately, this can be one of the very most difficult skills to obtain (Opening 2009). Taking care of time appropriately will reduce stress and increase production.
There are three basic steps to time management. The first rung on the ladder requires time for you to be reserve for planning and building priorities. The next step requires concluding the highest priority task whenever possible and finishing one task before you start another. In the final step the nurse must reprioritise what tasks will be achieved based on new information received (Marquis and Huston 2009).
We use planning in all aspects of our own lives. In nursing, we often call it a 'care plan, ' and nurse's use this process to guide their practice. The nursing process, or 'Assess, Plan, Use and assess (APIE), ' can be used successfully as a time management tool. 'APIE' is a organized, rational approach to planning and providing health care but if you change, this is to read this is a systematic, rational method of planning and accomplishing a workable time management plan this can be a great tool for nurses to use to control their time effectively (Brumm 2000).
Assess/Analyze - Pick up and organise data and form a affirmation of real or potential time management needs.
Plan/Prioritize - Formulate your plan. This involves devising goals and expected results, preparing priorities, and identifying interventions to help reach the goals.
Implement/Intervene - Put your plan into action.
Evaluate - Assess your results and observe how you measure up against your targets.
There will be regular demands on my time and attention and it can be difficult to recognize exactly what my priorities should be. In patient care, priorities can change rapidly and I am going to have to be in a position to constantly re-assess situations and respond correctly. Priority setting up is the procedure of establishing a preferential collection for addressing medical interventions. The nurse starts planning by deciding which treatment requires attention first, which second and so forth. Rather than rank-ordering interventions, nurses can group them as having high, medium, and low top priority. Life intimidating problems such as lack of respiratory or cardiac function are specified as high goal. Health-threatening problems, such as serious illness and lowered coping potential, are allocated medium top priority because they may result in delayed development or cause destructive physical or psychological changes. A low-priority problem is the one that arises from normal developmental needs or that requires only minimal nursing support (Kozier et al 2008).
The assumption is the fact that priorities can be established, and decisions made in regards to what is most important, and that can be followed by appropriate nursing activities. To determine priorities is to question what will be the outcome if this isn't done immediately.
During this experience questioning 'what would be the result of not supporting the health good care assistant?'
The patient would have had to hold back whilst I researched the drug and would have been left lying in urine and faeces. This could cause skin area excoriation to the individual and they would have been left unpleasant and undignified. I'd not need been providing a higher standard of practice and treatment as stated in the NMC (2008a) and I could be held in charge of this as a RN. Bladder control problems and faecal incontinence should be monitored in a fashion that is unobtrusive, reliable, and comfortable. The individual should be attended to quickly, to be able to prevent skin surface damage, relieve soreness and restore dignity. Nurses have to be aware of the potential skin issues that may derive from incontinence (Baillie 2005). The occurrence of wetness from urine and sweat boosts friction and shear, skin area permeability and microbial weight (Jeter and Lutz 1996). If a patient has been incontinent of urine and faeces, their relationship can cause the forming of ammonia, resulting in a rise in pH and an increase in the experience of faecal enzymes that destruction your skin (Baillie 2005). The need for changing a soiled product rapidly in cases of faecal incontinence to prevent skin excoriation has also been emphasised by Gibbons (1996). I have to act all the time to identify and minimise risk to patients and clients (NMC 2008a).
A research article and information story about university student nurses and bedside attention produced a extraordinary response on nursingtimes. net. The analysis writers Helen Allan and Pam Smith (2010) speak out stating that given the current pressures, trained nurses cannot deliver bedside good care. The perception is the fact technical health care is valued in addition to bedside care as a source of learning for students' future jobs, leaving them sense unprepared to be documented nurses. Their research proved that students conceptualize nursing in a different way to qualified personnel because of an intensified department of labour between registered and non-registered medical personnel. As students, we often monitor health care assistants undertaking bedside health care and signed up nurses undertaking technological tasks. The lack of clear role models leads students to question bedside health care within their learning and put better value on learning complex skills. In relation to my reflective experience my coach suggested the specialized task in researching the medicine was the priority with regards to the bedside health care of the individual it is therefore unsurprising to find that student nurses are unclear as to what is a way to obtain learning in planning for our tasks as Registered Nurses. Helping patients with personal cleanliness is one of the very most fundamental and important relationship-building skills open to nurses, no matter their seniority and scientific experience, university student nurses should accept these opportunities while we do not have the other time pressures and we may then reflect on our activities. These skills will establish invaluable in providing, overseeing and assessing meaningful, holistic care (Bowers 2009).
Registered Nurses maintain a position of responsibility and other folks rely on them. They are expertly accountable to the Medical and Midwifery Council (NMC), as well as developing a contractual accountability with their company and are accountable to regulations for their actions. The NMC (2008a) code state governments that 'As a specialist, you are individually accountable for actions and omissions in your practice and should always be able to justify your decisions'.
The NMC (2008a) code outlines the expectations that I have to work corresponding to, what is expected of me as a authorized professional by colleagues, employers, and people of the general public. It also describes what my professional responsibilities and accountabilities are. I may sometimes be confronted with situations, which will require me to test, and question things that they are asking me to do easily feel that these things are unsafe or are not in the best interests of the patient or organisation. It really is well recognized that it could be difficult to handle these issues credited to factors such as concern with the consequences, humiliation, and insufficient support like in my experience as stated above. Semple and Kenkre (2002) explain that the UKCC (2001) [now the NMC] reported the research of Moira Attree, which outlined that fact that nurses are often reluctant to raise concerns about benchmarks of treatment because they feared either inaction or retribution from employers. Nurses may also be inhibited by fears to be ostracised by the team if deciding to speak out against poor practice. This is another facet of my individual professional practice, which requires development, and I am going to make an effort to question situations in the future if I feel they are not in the needs of the patient.
Being stressed by work and time constraints will lead to increased errors, the omission of important tasks and general feelings of stress and ineffectiveness. Time management is an art, which is learned and improves with repetition (Marquis and Huston 2009).
Literature promptly management in medical is mainly unreliable, providing lots of tips about 'how to' manage time, along with information of functions or strategies. The order for thinking about the process varies, ranging from setting targets as the first step to working out how time is being used with the aid of time logs (Waterworth 2003). Determining the importance of responsibilities or priorities is area of the process, even though stage at which this should occur varies between writers. The primary theme in literature is the fact nurses need to think about their own time management, with the main message being that each nurses can deal with their time. The truth of energy management in medical practice has been at the mercy of experimental investigations, although studies on nurses' work business have found time management problematic, with nurses compensating for insufficient time by expanding strategies in an attempt to complete their work (Bowers et al. 2001).
Conclusion
Time management is a energetic process and will go together with good prioritising skills. If you cannot prioritise you, will spend your time and be inefficient. This may cause stress to yourself and your fellow associates, as well as leading to potential harm to your patients. An efficient way to organising your time and effort can be to use the medical process as described in the essay to Analyze, Prioritize, Intervene and assess.
After my research into time management and prioritising, I believe my mentor was wrong to question my time management skills. I had developed thought about that was the greater priority in this example and I still think that the individual was. The individual would have been vulnerable from skin excoriation and would have been left uneasy and undignified. Being a Registered Nurse, I am in charge of my actions and in the future, if the same situation arose again I feel that I'd not do anything different apart from to speak up and justify my decisions. I identified and minimised risk to that patient and as a RN, I will carry a posture of responsibility and other people will count on me. Although declaring this, my priorities as a RN may be different to people as students nurse and my continuing professional development will be extremely important. I must make the care of my patients my first matter all the time, treating them as individuals and respecting their dignity (NMC 2008a).
Action Plan
With the increasing emphasis on efficiency and effectiveness in healthcare, how I manage my time will be an important concern. Time management is recognized as an important component of work performance and medical practice. Like a newly qualified Registered Nurse, I will have to have excellent time management skills and also prioritise care properly.
To achieve this I am going to:
Break down my day to find out how long it requires me to do certain responsibilities.
Using the medical process as a tool, I will write a list in goal order and mix of tasks because they are completed and I will keep assessing my list during the shift.
I will delegate responsibilities to other associates of the team where necessary.
Through the reflection of the experience, I am now aware that I also need more development to concern and question things that Personally i think are not in the needs of the patients.
To accomplish that I am going to:
I will speak up and justify my actions at all times.
I will research more into assertiveness and assurance skills.
Word Count up: 2867.
